Osteoporosis Silently Steals Bone Strength

It’s Bad to the Bones

If you have chest pain or shortness of breath, you might have heart disease. If you feel fatigued and hopeless, you might have depression. If you have inflammation, pain and stiffness, you might have arthritis. But imagine having no symptoms at all while a disease progresses in your body without any signs or pain. That’s why osteoporosis is called “the silent thief.” Doctors make no bones about it; osteoporosis will creep up on you.

Tallahassee third-grade teacher Monica Napier was only 44 years old when she was diagnosed with osteoporosis in 2004. Her mother had just been diagnosed at the age of 70, and Napier thought she should probably talk to her doctor about it.

“I had a DEXA (Dual Energy X-ray Absorptiometry) scan, and honestly, I never thought they would diagnose me with osteoporosis at that time,” Napier remembers. “I thought, ‘I’m too young.’ When you think of osteoporosis, you think of a woman in her 60s or 70s. I didn’t expect to have it. I expected them to say, ‘You have the beginning signs of the disease.’ But I’m so glad I got screened. Now I’m on medication to treat it.”

If not prevented or if left untreated, osteoporosis can progress painlessly until a bone breaks. These fractures typically occur in the hip, spine or wrist. Any bone can be affected, but of special concern are fractures of the hip and spine. A hip fracture almost always requires hospitalization and major surgery. It can impair a person’s ability to walk unassisted and may cause prolonged or permanent disability or even death. Spinal or vertebral fractures also have serious consequences, including loss of height, severe back pain and deformity.

Ten million Americans already have osteoporosis and 34 million more have low bone mass, placing them at increased risk for developing osteoporosis and the fractures it causes. Eighty percent of those affected by osteoporosis are women.

Dr. Terry Sherraden is an endocrinologist who has seen many patients with the disease during his 24 years practicing in Tallahassee.

“There are usually no symptoms until a fracture occurs. Then, of course, that is a very painful event,” he says. “Osteoporotic fractures can occur with really no trauma, such as a cough causing rib or vertebral fractures. Even leaning over the washer to take out laundry can cause rib fractures. A simple fall can lead to a fractured wrist, vertebra or hip.”

The number of fractures due to osteoporosis is expected to rise to more than 3 million by the year 2025.

“The ‘pain of osteoporosis’ comes from fractures,” Sherraden says. “If there were no fractures, we wouldn’t worry about loss of bone density. By the time the fracture occurs, though, the damage is already done. Our biggest job is to prevent bone loss so that we prevent fractures, and to do that we have to start early.”

He continues: “Children need to be building bone density by eating a healthy, calcium-rich diet and by getting lots of exercise to strengthen their bones. Peak bone mass occurs at about 20 to 30 years of age, and from then on it is our job to prevent the loss of bone mass so that fractures are unlikely. Young people need to be adopting behaviors that help keep their bones healthy and strong so that they never have osteoporotic fractures.”

Between 85 percent and 90 percent of adult bone mass is acquired by age 18 in girls and 20 in boys. Building strong bones during childhood and adolescence can help to prevent osteoporosis later in life. According to the National Osteoporosis Foundation, the following five steps together can optimize bone health and help prevent osteoporosis:

  • Get the daily recommended amounts of calcium and vitamin D.
  • Engage in regular weight-bearing and muscle-strengthening exercise.
  • Avoid smoking and excessive alcohol.
  • Talk to your health care provider about bone health.
  • Have a bone density test and take medication when appropriate. Post-menopausal women are usually thought to be the largest risk group, but men can be osteoporotic as well.

“Older people have a higher risk of fracture than younger people with the same bone density,” Sherraden says. “Certain people are more likely to develop osteoporosis than others. While we have no control over some of these risk factors, there are others we can change. Many of the choices we make each day can affect our bones. By making healthier choices, we can help to reduce the risk of osteoporosis, as well as the painful fractures it can cause.”

Risk factors for osteoporosis are:

  • Being female
  • Older age
  • Family history of osteoporosis or broken bones
  • Being small and thin
  • Certain race/ethnicities such as Caucasian, Asian or Hispanic/Latino (although African-Americans are also at risk)
  • History of broken bones
  • Low sex hormones
  • Poor diet
  • Inactive lifestyle
  • Smoking
  • Alcohol abuse
  • Certain medications such as steroids, some anticonvulsants and others
  • Certain diseases and conditions such as anorexia nervosa, rheumatoid arthritis, gastrointestinal diseases and others

If you want to find out if you have osteoporosis, you can do what teacher Napier did and ask your doctor for a DEXA scan. These specialized tests can measure bone mineral density in various sites of the body. And although there is no cure for osteoporosis, it can be treated.

“We want our patients to optimize their diet, especially adequate calcium and vitamin D, to get routine weight-bearing exercise, and in many cases medications can be helpful,” Sherraden says. “Most of the medications can reduce the risk of sustaining an osteoporotic fracture by approximately 50 percent.”

Tallahassee registered dietitian Pam Schmidt says calcium is necessary for bones to stay strong, and every cell in the body needs calcium to work properly.

“Maintaining an adequate calcium intake is an important step toward good bone health throughout life,” she says. “Luckily, there are many foods that contain calcium. Most people know dairy foods contain calcium but are unaware that low-fat and fat-free milk, yogurt and cheese actually have more calcium per serving than the regular versions. And did you know a cup of frozen broccoli has 94 milligrams of calcium? Or that 10 dried figs have 270 milligrams? Dry-roasted almonds pack 75 milligrams into each ounce. Many foods are made with added calcium. Look for calcium-fortified orange juice, cereals, breads and other foods.”

Napier says her diagnosis has changed how she lives her life, and she wants to share that knowledge with others. Her advice: “Know your family history. I encouraged my daughter to start taking calcium supplements when she was younger. I tell my friends to get a regular checkup. Get a DEXA scan. Do the weight-bearing exercises. Educate yourself.”

Contributing writer Triston V. Sanders is an executive producer and news anchor for WCTV. Watch her televised medical segment, “Health Matters,” weekday mornings on “The Good Morning Show” on WCTV.

Are You At Risk for Developing Osteoporosis?

The more times you answer “yes,” the greater your risk for developing osteoporosis.

  • Do you have a small, thin frame and/or are you Caucasian or Asian?
  • Have you or a member of your immediate family broken a bone as an adult?
  • Are you a postmenopausal woman?
  • Have you had an early or surgically induced menopause?
  • Do you smoke cigarettes or drink alcohol in excess?
  • Have you taken, or are you taking, immunosuppressive medications or chemotherapy to treat cancer?
  • Have you taken high doses of thyroid medication or used more than 5 milligrams a day of glucocorticoids (for example, prednisone) for three or more months?
  • Is your diet low in dairy products and other sources of calcium?
  • Are you physically inactive?
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